PROJECT SUMMARY/ABSTRACT This is an application for a K23 Patient-Oriented Mentored Career Development award by Daniel Olson, MD. The proposed research will assess the clinical and socioeconomic impacts of influenza in a cohort of agricultural workers in Guatemala, evaluate clinical, biological, and socioeconomic predictors of influenza- associated absenteeism, and measure the effectiveness of workplace-based influenza vaccine in reducing disease and absenteeism. Candidate. Dr. Olson is a board-certified pediatrician and infectious disease (ID) specialist who is an Assistant Professor in the Department of Pediatrics at the University of Colorado (CU) School of Medicine, with a secondary appointment in the Department of Epidemiology in the Colorado School of Public Health. Training. Through hands-on mentored research, didactic coursework, and conferences/seminars, Dr. Olson?s K23 Career Development aims include: 1) Develop and formalize skills in clinical trial design and implementation, 2) Establish expertise in vaccinology, and 3) Obtain competencies to manage and develop a high quality global health research site. Mentors/Environment. Dr. Olson has assembled a diverse team of mentors, each with specific skills in his proposed research and career development aims. Dr. Edwin Asturias, an Associate Professor of Pediatric ID and Epidemiology at CU and the Jules Amer Chair of Community Pediatrics, will be his primary mentor. The remaining mentorship committee includes Dr. Lee Newman, Dr. Kathryn Edwards, Dr. May Chu, and Dr. Frederick Hayden, providing a diverse group of senior level mentors with broad experience and expertise. Research. Low- and middle-income countries (LMICs) continue to suffer a disproportionate burden of influenza disease. Workplace influenza vaccination programs may offer a cost-effective strategy to limit absenteeism and lost productivity due to influenza. Agricultural workers represent an economically strategic workforce in Latin America, and the drivers of illness-associated absenteeism, such as influenza, are unknown. The CU research site in Guatemala has an established cohort of 2,706 agricultural workers from a nearby banana plantation and a well-trained research team. To better understand the impact of influenza on agricultural workers and the drivers of work absenteeism, we aim to 1) Evaluate the clinical and socioeconomic impacts of influenza on a cohort of Guatemalan agricultural workers and determine predictors of work absenteeism due to influenza, and 2) Measure the effectiveness of influenza vaccination on disease incidence, absenteeism, and job performance in the same cohort. We hypothesize that influenza places a significant burden on agricultural workers, that specific clinical, biological, and socioeconomic predictors may be associated with greater absenteeism, and that a workplace-based influenza vaccine program will significantly reduce clinical disease and influenza-associated absenteeism.